A new era for oral anticoagulation? Old and new anticoagulant drugs

The expanding demand for long-term antithrombotic therapy and the major limitations of the vitamin-K antagonists, namely their narrow therapeutic range, numerous drug interactions and need for laboratory monitoring, have stimulated the development of new antithrombotic agents. Direct thrombin inhibitors and factor Xa inhibitors are the new classes of orally available anticoagulants that are most advanced in development. Large clinical trials evaluate several compounds both in the primary and secondary prevention of venous thromboembolism and in the prevention of cardioembolism in patients with atrial fibrillation.

[1]  Palle Petersen,et al.  Ximelagatran vs warfarin for stroke prevention in patients with nonvalvular atrial fibrillation: a randomized trial. , 2005, JAMA.

[2]  R. Wallis,et al.  Hirudins: From Leeches to Man , 1996, Seminars in thrombosis and hemostasis.

[3]  B. Eriksson,et al.  A Once-Daily, Oral, Direct Factor Xa Inhibitor, Rivaroxaban (BAY 59-7939), for Thromboprophylaxis After Total Hip Replacement , 2006, Circulation.

[4]  B. Eriksson,et al.  Fondaparinux vs enoxaparin for the prevention of venous thromboembolism in major orthopedic surgery: a meta-analysis of 4 randomized double-blind studies. , 2002, Archives of internal medicine.

[5]  J. Weitz,et al.  Emerging anticoagulants for the treatment of venous thromboembolism , 2006, Thrombosis and Haemostasis.

[6]  Po Box.  Ximelagatran versus low-molecular-weight heparin and warfarin for the treatment of deep vein thrombosis: a randomized trial , 2005 .

[7]  B. Eriksson,et al.  The direct thrombin inhibitor melagatran followed by oral ximelagatran compared with enoxaparin for the prevention of venous thromboembolism after total hip or knee replacement: the EXPRESS study , 2003, Journal of thrombosis and haemostasis : JTH.

[8]  S. Yusuf,et al.  Effects of fondaparinux on mortality and reinfarction in patients with acute ST-segment elevation myocardial infarction: the OASIS-6 randomized trial. , 2006, JAMA.

[9]  J. Hirsh,et al.  New anticoagulant drugs: the Seventh ACCP Conference on Antithrombotic and Thrombolytic Therapy. , 2004, Chest.

[10]  Silvia G Priori,et al.  ACC/AHA/ESC 2006 guidelines for the management of patients with atrial fibrillation--executive summary: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the European Society of Cardiology Committee for Practice Guidelines (Writing Commit , 2006, Journal of the American College of Cardiology.

[11]  M. Gent,et al.  BAY 59‐7939: an oral, direct Factor Xa inhibitor for the prevention of venous thromboembolism in patients after total knee replacement. A phase II dose‐ranging study , 2005, Journal of thrombosis and haemostasis : JTH.

[12]  H. Büller,et al.  Fondaparinux or enoxaparin for initial treatment of symptomatic deep venous thrombosis: Randomized trial , 2004 .

[13]  H. Büller,et al.  A new oral direct thrombin inhibitor, dabigatran etexilate, compared with enoxaparin for prevention of thromboembolic events following total hip or knee replacement: the BISTRO II randomized trial , 2005, Journal of thrombosis and haemostasis : JTH.

[14]  J. Hirsh,et al.  The pharmacology and management of the vitamin K antagonists: the Seventh ACCP Conference on Antithrombotic and Thrombolytic Therapy. , 2004, Chest.

[15]  J. Herbert,et al.  The Synthetic Pentasaccharide Fondaparinux: First in the Class of Antithrombotic Agents that Selectively Inhibit Coagulation Factor Xa , 2002, Seminars in thrombosis and hemostasis.

[16]  M Gent,et al.  Subcutaneous fondaparinux versus intravenous unfractionated heparin in the initial treatment of pulmonary embolism. , 2003, The New England journal of medicine.

[17]  J Ean,et al.  Efficacy and safety of recombinant human activated protein C for severe sepsis. , 2001, The New England journal of medicine.

[18]  J. Heit,et al.  Thrombophilia and new anticoagulant drugs. , 2004, Hematology. American Society of Hematology. Education Program.

[19]  S. Olsson,et al.  Stroke prevention with the oral direct thrombin inhibitor ximelagatran compared with warfarin in patients with non-valvular atrial fibrillation (SPORTIF III): randomised controlled trial , 2003, The Lancet.

[20]  Salim Yusuf,et al.  Comparison of fondaparinux and enoxaparin in acute coronary syndromes. , 2006, The New England journal of medicine.